Anger is a powerful emotion. One doesn’t have to be a patient or a nursing aide (caregiver) to experience it.
When a patient gets angry, it is easy to be in the same hostile mood in return. It is only human, you might think, but as a nursing aide or home care aide, you cannot just mirror the patient’s anger.
You might have tried several strategies in the past to handle a fiery situation, like counting up to ten slowly. You might have tried breathing deeply in and out, or thinking of happy thoughts while you are being shouted at but still feel that the patient is eternally angry. You might think that it is unfair to be the target of the patient’s fury, but being a caregiver puts you in a spot where most of the understanding and adjustment must come from you.
Maintaining one’s calmness as a CNA or HCA when confronted by an angry patient is not as easy as 1-2-3, but with enough practice and the right mindset, you can save yourself from unnecessary hurtful feelings, and you might be able to keep your patient from being all the more frustrated.
When the patient is angry, never (ever) yell back. Just Listen.
Keeping one’s calm when someone is angry at you, especially if you have been putting everything in to taking care of this person, is difficult at first, but it is possible. You could do this by just listening intently to what the patient has to say. It would also be helpful to maintain eye contact to reinforce the trust.
Would it help if you say, ”Please calm down?” No, because it becomes more difficult for the patient to not be able to say what they want.
Would it help to reason with them, like telling a patient with dementia that what they are thinking is ”not true”? Again, no, because most likely their reasoning is impaired by their illness.
When a patient is visibly upset, it is best to go back to basics: keep calm, and just listen.
Next, tell yourself not to take it personally.
Try to understand that the patient may be in a lot of pain, or has worsening symptoms. Be objective in assessing the situation. Even if they are lashing out at you, it does not necessarily mean that they are angry at you. They are just angry. Period. At this point, being indifferent helps in pulling oneself out of the situation, and in focusing on what triggered the emotion of the patient.
What do you say instead?
Validate the patient’s feelings. Say something like, ”I know you are upset.” Let the patient know that you are acknowledging their distress and that you want to help.
Learn how to say ”Yes“ a lot. Do not contradict yourself if you can help it. If your patient hears ”no“ all of the time, their feelings of frustration and of being without control will be heightened. You have to learn how to be creative with your response, be flexible, and allow them to do things within the limits of their safety. If for example, they want to put on two more extra layers of clothes in the summer, instead of saying ”no“ and explaining why they can’t, you can help them choose loose and thin clothes “that really looks nice” on them. And then lower the room temperature a little bit. This strategy works both ways. You will not evoke the patient’s anger, plus you saved yourself a needless confrontation.
Learn from the situation.
Learning from the situation makes you a better caregiver. Note the details, and patterns of the patient’s outbursts. What triggers the patient’s anger? What time of day does it usually occur? What usually makes the patient angry? Such observations will help you prevent future hostile episodes.
Lastly, be creative.
Nursing aides and home care aides should use a variety of techniques to prevent a patient from being angry. Play their favorite music. Sit with them as they bring back happy memories by looking at photo albums. Introduce new hobbies to them or reinforce activities of interest. Indulge them once in a while.
If you did happen to get angry with a patient, do not beat yourself up over it. Talk to someone about your feelings. It always helps to talk to someone.
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